HomeMy WebLinkAboutBuilding Permit 00-0911
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
'i/Wd3
Ivfohct (:Yv~~,
PERMIT NO. ~ 0... q {, (
SCHEDULED
OWNER
CONTR.
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
A- 0 FIREPLACE FINAL
o ~LINE AIR TST
~ ,,~~
FtHAt-.
COMMENTS:
tvWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~
OwnerlContr.
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETYI
Il'iSNOTl
-".----,..,-,--.-..-~- -..."---__.___~_......-___._..____.___..___...-m
7 - 11- 00
12. /50
BU
1'.SIZE
(Height)
:J 0 70
12. NO. OF STORIES
~
jk:' ':)
~~
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~'7utO
1.
2.
q:;--:V 3.
1r7/'lY
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bonom)
12. SITE ADDRESS
I Lf-Oc.<j GR.Ii"€;Vw/ty livE.
3. LEGAL DESCRIPTION
1. DATE
(DeptnL.
"1.~
LOT
.~
/
/-hrP.6'oL Wb~ I
BLOCK
PID .zC:;-Zlq- ODS-I)
5. ARCHITECT
(Name)
p,Ac.ljcLtJj{
(Name)
(Address)
J u ofo9 GRCC"'lNIIY /lvt,
(Address)
(Tel. No.) 'p, - '19". ;)5"...
r/l,O)(. Lit". ./tI-' 5.J7J.
(Tel. No.)
13. TYPE OF CONSTRUCTION
WdCb FR."..., €
14. FLOOR AREA APPORTIONMENT USE
SI,,;6(C Ffjn"l.Y
ADDITION
4. OWNER
.DE r7....J
9'-1_707 - r.9s-'1
15. NUMBER OF OCCUPANTS OR SEATS
3
OCCUPANTS
6. BUILDER (Name) (Address~
11,.,(IlI(Il~ e."il./ll; b I.)~ '/7 AJI ~.LLld II VE S.
C'....r/l-i1Ct-oJt..s Bult"sv.ui ,"'" 5">..337
. SEATS
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing"" Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Anic 0 Re-siding 0 Finish Basement 0 16. PROJECT COSTNALUE
ChimneyO Misc. "3 '6 I "07. J 3
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS \10. CULVERT SIZE 17. COMPLEnON DATE
Sq. Ft. Width Depth Yes Qlij) I 0 - 3 ) - 0 0
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submined plans. I am aware that the
building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
aa/t.93'61
(Tel. No.)
r
- SETBACKS: Required
Actual
Signature
License No.
Dale
x
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT V ALUA TION
2-,~
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
u:;~
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
State Surcharge ............................. <I:
7c/<ts
I_~
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ................. ............ $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 'ill:>. C/V
Paid 7/0 . 07./ ReceiP'.1.!" oS 3 t e4-~'7
Date I j). 4' () By /t{V'--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin~nce and may proceed aUrequested. This document wilen
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Penalty ....................................... II:
Plumbing Permit Fee ....................... .It
Mechanical Permit Fee ..................... L
Sewer & Water Permit ...................... !I:
City Planner
Date
Special Conditions n any
24 hour notice for all inspections 447-9850